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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000664

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Leontine MargaretClannon Sex Female

Date of Birth October 1, 1923 Place of Birth Petit de GratCounty of Richmond

Name of Father Hugh Clannon MAIDEN NAME of Mother Alexina Samson

Were the Parents married at the time of the Birth? Yes

Residence of Father when child was born Little Anse Richmond Co. Ns Present address of Father Deceased

Occupation of Father at Birth of child Carpenter Place of birth of Father L'Ardoise, Richmond Co., NS

Race Name and present address of Physician in attendance at birth

Signature of Applicant Leontine M. Clannon Address of Applicant Box 96, Petit de Grat, Richmond Co., NS Date 7 July 1978

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Leontine MargaretClannon

Born at Petit de Grat in the County of Richmond

That Leontine MargaretClannon Whose Birth is sought to be registered was

born at Petit de Grat Richmond County on October 1, 1923

My knowledge of the fact and date of such Birth is based on the following Circumstances:

I was at that time 17 years of age and living at home when my mother delivered the baby, Leontine Margaret Clannon. Also this fact is recorded by Alexina Clannon (mother) in a small book, sort of diary.

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